Neurocognitive Outcomes of Infants of Diabetic Mothers

In this study, we hypothesize that the adverse fetal events common in the diabetic pregnancy (i.e. iron deficiency, hypoxemia, and hypoglycemia) will have a deleterious and specific effect on the hippocampus. This should result in selective impairments in explicit memory due to the established vulnerability of this structure to these metabolic disturbances. Our results thus far have established a consistent pattern of deficits in recognition memory, from birth through two years of age, as inferred from electrophysiological data (event-related potentials) and behavioral data (Elicited Imitation). The goal of this protocol is to continue to study our cohort of children as they enter the elementary school years. We will do this by conducting detailed electrophysiological (ERPs), metabolic (fMRI), anatomic (MRI), and behavioral (neuropsychologic) studies on our current samples of IDMs and comparison children. Given that approximately 10% of all pregnancies are complicated by maternal diabetes, the current project has important implications for public health.

Specifically, our aims are as follows:

Confirm our previous data, which indicate that IDMs suffer from deficits in memory.

Determine whether deficits in other cognitive functions emerge as our study population makes the transition to school age; specifically, do we observe deficits in striatal or prefrontal functions, particularly executive functions? And, is there an association between such deficits and school performance?

Characterize further which neural circuits have been compromised by the adverse fetal environment that is common among IDMs; specifically, confirm our prediction of hippocampal damage (as inferred from reduced hippocampal volume and/or metabolism and/or neurophysiology) and/or whether we observe damage to structures/circuits that feed to and from the hippocampus, notably prefrontal cortex and/or striatum and/or whether we observe reductions in white matter due to prenatal iron deficiency

These specific aims will be addressed by conducting detailed electrophysiological (ERPs), metabolic (fMRI), anatomic (MRI) and behavioral (neuropsychologic) studies on our current sample of IDMs, along with our current sample of comparison children.